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1.
Cell ; 187(6): 1402-1421.e21, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38428422

RESUMEN

Neonates are highly susceptible to inflammation and infection. Here, we investigate how late fetal liver (FL) mouse hematopoietic stem and progenitor cells (HSPCs) respond to inflammation, testing the hypothesis that deficits in the engagement of emergency myelopoiesis (EM) pathways limit neutrophil output and contribute to perinatal neutropenia. We show that fetal HSPCs have limited production of myeloid cells at steady state and fail to activate a classical adult-like EM transcriptional program. Moreover, we find that fetal HSPCs can respond to EM-inducing inflammatory stimuli in vitro but are restricted by maternal anti-inflammatory factors, primarily interleukin-10 (IL-10), from activating EM pathways in utero. Accordingly, we demonstrate that the loss of maternal IL-10 restores EM activation in fetal HSPCs but at the cost of fetal demise. These results reveal the evolutionary trade-off inherent in maternal anti-inflammatory responses that maintain pregnancy but render the fetus unresponsive to EM activation signals and susceptible to infection.


Asunto(s)
Inflamación , Interleucina-10 , Mielopoyesis , Animales , Ratones , Embarazo/inmunología , Feto , Hematopoyesis , Células Madre Hematopoyéticas/citología , Inflamación/inmunología , Interleucina-10/inmunología , Animales Recién Nacidos , Femenino
2.
Cell ; 183(6): 1650-1664.e15, 2020 12 10.
Artículo en Inglés | MEDLINE | ID: mdl-33125898

RESUMEN

Correction of disease-causing mutations in human embryos holds the potential to reduce the burden of inherited genetic disorders and improve fertility treatments for couples with disease-causing mutations in lieu of embryo selection. Here, we evaluate repair outcomes of a Cas9-induced double-strand break (DSB) introduced on the paternal chromosome at the EYS locus, which carries a frameshift mutation causing blindness. We show that the most common repair outcome is microhomology-mediated end joining, which occurs during the first cell cycle in the zygote, leading to embryos with non-mosaic restoration of the reading frame. Notably, about half of the breaks remain unrepaired, resulting in an undetectable paternal allele and, after mitosis, loss of one or both chromosomal arms. Correspondingly, Cas9 off-target cleavage results in chromosomal losses and hemizygous indels because of cleavage of both alleles. These results demonstrate the ability to manipulate chromosome content and reveal significant challenges for mutation correction in human embryos.


Asunto(s)
Alelos , Proteína 9 Asociada a CRISPR/metabolismo , Cromosomas Humanos/genética , Embrión de Mamíferos/metabolismo , Animales , Secuencia de Bases , Blastocisto/metabolismo , Ciclo Celular/genética , Línea Celular , Deleción Cromosómica , Roturas del ADN de Doble Cadena , Reparación del ADN por Unión de Extremidades/genética , Implantación del Embrión/genética , Proteínas del Ojo/genética , Fertilización , Edición Génica , Reordenamiento Génico/genética , Sitios Genéticos , Genoma Humano , Genotipo , Heterocigoto , Células Madre Embrionarias Humanas/metabolismo , Humanos , Mutación INDEL/genética , Ratones , Mitosis , Sistemas de Lectura Abierta/genética , Polimorfismo de Nucleótido Simple/genética
3.
J Emerg Med ; 66(5): e555-e561, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38580514

RESUMEN

BACKGROUND: Management of acute shoulder dislocation in the emergency department (ED) is common. OBJECTIVE: This study describes the rate, risk factors, and length of stay (LOS) associated with shoulder dislocation reduction failure in the ED. METHODS: The study was a retrospective case-control study of patients 18 years and older presenting to the ED with acute shoulder dislocation who underwent attempted reduction. Patients with successful reduction on post-reduction first confirmatory imaging are compared with those requiring multiple attempts. RESULTS: Of 398 ED encounters when a shoulder reduction was attempted in the ED, 18.8% (75/398 [95% CI 15.2-22.9%]) required multiple reduction attempts. Patients with successful reduction on first confirmatory imaging were more commonly male (80.2% [95% CI 75.6-84.3%] vs. 68.0% [95% CI 56.8-77.8%]; p = 0.0220), discharged home from the ED (95.4% [95% CI 92.6-97.3%] vs. 84.0% [95% CI 74.4-91.0%]; p = 0.0004), reduced using a traction/countertraction technique (42.1% [95% CI 36.8-47.6%] vs. 29.3% [95% CI 19.9-40.4%]; p = 0.0415), and less likely to have a pre-reduction fracture (26.0% [95% CI 21.4-31.0%] vs. 45.3% [95% CI 34.4-56.7%]; p = 0.0010). Mean length of stay (LOS) for those with successful reduction on first confirmatory imaging was 2 hours and 8 minutes shorter than for those with more than one attempt (p < 0.001). CONCLUSIONS: The rate of failed first-pass reduction is higher than previously reported. Furthermore, the ED LOS was significantly longer in patients requiring multiple attempts. Knowledge of the failure rate and risk factors may raise physician awareness and guide future studies evaluating approaches for verification of reduction success.


Asunto(s)
Servicio de Urgencia en Hospital , Tiempo de Internación , Luxación del Hombro , Humanos , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Masculino , Estudios Retrospectivos , Femenino , Luxación del Hombro/terapia , Luxación del Hombro/diagnóstico por imagen , Estudios de Casos y Controles , Persona de Mediana Edad , Tiempo de Internación/estadística & datos numéricos , Adulto , Anciano , Manipulación Ortopédica/métodos , Manipulación Ortopédica/estadística & datos numéricos , Factores de Riesgo
4.
J Environ Manage ; 345: 118526, 2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-37418824

RESUMEN

Methyl mercury (MeHg) concentrations in boreal headwater streams are influenced by complex natural processes and disturbances such as forestry management. Understanding drivers of MeHg within boreal streams in Ontario, Canada, is of particular interest as there are legacy MeHg concerns. However, models accounting for the complexity of underlying processes have not yet been developed. We assessed how catchment characteristics and stream water chemistry influence MeHg concentrations within 19 watersheds of the Dryden - Wabigoon Forest in Ontario, Canada, using a structural equation modelling (SEM) approach. Despite the study area encompassing a large variation of boreal forest watersheds in the Canadian Shield, our SEM had substantial explanatory power across the region (χ251 = 45.37, p-value = 0.70, R2 = 0.75). Nitrate concentrations (p-value <0.001), water temperature (p-value = 0.002), and the latent watershed characteristic (p-value <0.001) had a positive influence on MeHg concentrations once variable interactions were accounted. Due to the inherent strengths of applying an SEM approach, we describe two plausible pathways driving MeHg concentrations: 1) indirect effect of forest-derived nutrients increases in-situ MeHg production in Dryden - Wabigoon Forest streams, and 2) direct supply of MeHg from inundated soils following consistent precipitation and inundation events (i.e., fill, sit, and spill).


Asunto(s)
Mercurio , Contaminantes Químicos del Agua , Mercurio/química , Ontario , Taiga , Bosques , Agua , Contaminantes Químicos del Agua/química , Monitoreo del Ambiente
5.
Environ Sci Technol ; 56(2): 1433-1444, 2022 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-34979084

RESUMEN

We examined the composition and spatial correlation of sulfur and mercury pools in peatland soil profiles by measuring sulfur speciation by 1s X-ray absorption near-edge structure spectrocopy and mercury concentrations by cold vapor atomic fluorescence spectroscopy. Also investigated were the methylation/demethylation rate constants and the presence of hgcAB genes with depth. Methylmercury (MeHg) concentration and organic disulfide were spatially correlated and had a significant positive correlation (p < 0.05). This finding is consistent with these species being products of dissimilatory sulfate reduction. Conversely, a significant negative correlation between organic monosulfides and MeHg was observed, which is consistent with a reduction in Hg(II) bioavailability via complexation reactions. Finally, a significant positive correlation between ester sulfate and instantaneous methylation rate constants was observed, which is consistent with ester sulfate being a substrate for mercury methylation via dissimilatory sulfate reduction. Our findings point to the importance of organic sulfur species in mercury methylation processes, as substrates and products, as well as potential inhibitors of Hg(II) bioavailability. For a peatland system with sub-µmol L-1 porewater concentrations of sulfate and hydrogen sulfide, our findings indicate that the solid-phase sulfur pools, which have a much larger sulfur concentration range, may be accessible to microbial activity or exchanging with the porewater.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Disulfuros , Ésteres , Mercurio/análisis , Metilación , Suelo , Sulfatos
6.
Environ Sci Technol ; 56(24): 17615-17625, 2022 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-36445185

RESUMEN

Changes in sulfate (SO42-) deposition have been linked to changes in mercury (Hg) methylation in peatlands and water quality in freshwater catchments. There is little empirical evidence, however, of how quickly methyl-Hg (MeHg, a bioaccumulative neurotoxin) export from catchments might change with declining SO42- deposition. Here, we present responses in total Hg (THg), MeHg, total organic carbon, pH, and SO42- export from a peatland-dominated catchment as a function of changing SO42- deposition in a long-term (1998-2011), whole-ecosystem, control-impact experiment. Annual SO42- deposition to half of a 2-ha peatland was experimentally increased 6-fold over natural levels and then returned to ambient levels in two phases. Sulfate additions led to a 5-fold increase in monthly flow-weighted MeHg concentrations and yields relative to a reference catchment. Once SO42- additions ceased, MeHg concentrations in the outflow streamwater returned to pre-SO42- addition levels within 2 years. The decline in streamwater MeHg was proportional to the change in the peatland area no longer receiving experimental SO42- inputs. Importantly, net demethylation and increased sorption to peat hastened the return of MeHg to baseline levels beyond purely hydrological flushing. Overall, we present clear empirical evidence of rapid and proportionate declines in MeHg export from a peatland-dominated catchment when SO42- deposition declines.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Contaminantes Químicos del Agua , Ecosistema , Sulfatos , Monitoreo del Ambiente , Contaminantes Químicos del Agua/análisis , Mercurio/análisis , Óxidos de Azufre
7.
Ecotoxicol Environ Saf ; 220: 112354, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34116335

RESUMEN

Hydropower generation, a renewable source of electricity, has been linked to elevated methylmercury (MeHg) concentrations in impoundments and aquatic biota. This study investigates the impact of water level fluctuations (WLF) on MeHg concentrations in water, sediment, and fish. Using a set of controlled microcosm experiments emulating the drawdown/refill dynamics and subsequent sediment exposure to air experienced in reservoirs, we demonstrate that less frequent WLFs, and/or increased exposure of sediment to air, can lead to elevated MeHg concentrations in sediment, and total mercury (THg) and MeHg concentrations in water. In examining the effects of WLF frequency (two-day, weekly, and monthly), the monthly treatment displayed the highest THg and MeHg water levels, while the weekly treatment was characterized by the highest MeHg levels in the sediment. Our work supports emerging evidence that longer duration between WLF creates a larger surface area of sediment exposed to air leading to conditions conducive to higher MeHg concentrations in sediments and water. In contrast, THg, MeHg, and fatty acid trends in fish were largely inconclusive characterized by similar among-treatment effects and minimal temporal variability over the course of our experiment. This result could partly be attributed to overall low mercury levels and simple "worm-forage fish" food web in our experiment. To elucidate the broader impacts of water fluctuations on aquatic chemistry and biota, other factors (e.g., longer WLF cycles, dissolved organic matter, temperature, more complex food webs) which modulate both methylation rates and food web dynamics must be considered.


Asunto(s)
Mercurio/análisis , Movimientos del Agua , Contaminantes Químicos del Agua/análisis , Animales , Monitoreo del Ambiente , Peces/metabolismo , Cadena Alimentaria , Sedimentos Geológicos/química , Compuestos de Metilmercurio/análisis , Agua/química
8.
Environ Sci Technol ; 54(22): 14265-14274, 2020 11 17.
Artículo en Inglés | MEDLINE | ID: mdl-33138371

RESUMEN

Methylmercury (MeHg) is a bioaccumulative neurotoxin produced by certain sulfate-reducing bacteria and other anaerobic microorganisms. Because microorganisms differ in their capacity to methylate mercury, the abundance and distribution of methylating populations may determine MeHg production in the environment. We compared rates of MeHg production and the distribution of hgcAB genes in epilimnetic sediments from a freshwater lake that were experimentally amended with sulfate levels from 7 to 300 mg L-1. The most abundant hgcAB sequences were associated with clades of Methanomicrobia, sulfate-reducing Deltaproteobacteria, Spirochaetes, and unknown environmental sequences. The hgcAB+ communities from higher sulfate amendments were less diverse and had relatively more Deltaproteobacteria, whereas the communities from lower amendments were more diverse with a larger proportion of hgcAB sequences affiliated with other clades. Potential methylation rate constants varied 52-fold across the experiment. Both potential methylation rate constants and % MeHg were the highest in sediments from the lowest sulfate amendments, which had the most diverse hgcAB+ communities and relatively fewer hgcAB genes from clades associated with sulfate reduction. Although pore water sulfide concentration covaried with hgcAB diversity across our experimental sulfate gradient, major changes in the community of hgcAB+ organisms occurred prior to a significant buildup of sulfide in pore waters. Our results indicate that methylating communities dominated by diverse anaerobic microorganisms that do not reduce sulfate can produce MeHg as effectively as communities dominated by sulfate-reducing populations.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Contaminantes Químicos del Agua , Bacterias/genética , Sedimentos Geológicos , Lagos , Mercurio/análisis , Sulfatos
9.
Environ Sci Technol ; 54(17): 10533-10543, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32786342

RESUMEN

Tracing emission sources and transformations of atmospheric mercury with Hg stable isotopes depends on the ability to collect amounts sufficient for reliable quantification. Commonly employed active sampling methods require power and long pumping times, which limits the ability to deploy in remote locations and at high spatial resolution and can lead to compromised traps. In order to overcome these limitations, we conducted field and laboratory experiments to assess the preservation of isotopic composition during sampling of gaseous elemental mercury (GEM) with a passive air sampler (PAS) that uses a sulfur-impregnated carbon sorbent and a diffusive barrier. Whereas no mass independent fractionation (MIF) was observed during sampling, the mass dependent fractionation (MDF, δ202Hg) of GEM taken up by the PAS was lower than that of actively pumped samples by 1.14 ± 0.24‰ (2SD). Because the MDF offset was consistent across field studies and laboratory experiments conducted at 5, 20, and 30 °C, the PAS can be used for reliable isotopic characterization of GEM (±0.3‰ for MDF, ±0.05‰ for MIF, 2SD). The MDF offset occurred more during the sorption of GEM rather than during diffusion. PAS field deployments confirm the ability to record differences in the isotopic composition of GEM (i) with distance from point sources and (ii) sampled at different background locations globally.


Asunto(s)
Mercurio , Fraccionamiento Químico , Monitoreo del Ambiente , Isótopos , Mercurio/análisis , Isótopos de Mercurio/análisis
10.
Emerg Radiol ; 27(1): 37-40, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31485848

RESUMEN

INTRODUCTION: Point-of-care ultrasound (POCUS) education is a requirement of graduate medical education in EM. Milestones have been established to assess resident US competency. However, the delivery of POCUS education has not been standardized. This study aims to evaluate the impact of implementing a longitudinal, structured POCUS curriculum during EM residency on trainee competency and confidence. METHODS: A prospective study of PGY-3 trainees before and after implementation of a novel POCUS curriculum was performed over an 18-month period at an EM residency training program. Curriculum design included longitudinal POCUS application-based monthly electronic content, bi-monthly residency conference sessions, and hands-on rotations. PGY-3 resident's POCUS knowledge was assessed with a 38-question multiple-choice and image-based exam. Further, PGY-3 residents were surveyed regarding POCUS confidence. Survey results evaluated provider confidence, satisfaction with the novel curriculum, and overall perception of POCUS utility scored on a 1 (low) to 5 (high) scale. Results were evaluated using an unpaired t test for data analysis. RESULTS: Mean quiz scores of 8 pre-curriculum PGY-3 residents (84%; 95%CI 78.46-89.54) were not significantly different when compared with 13 post-curriculum PGY-3 residents (82%; 95%CI 77.11-86.89) (p = 0.6126). Survey results for pre-curriculum trainees across each section were 4.13 (95%CI 3.91-4.35), 3.68 (95%CI 3.32-4.04), and 4.33 (95%CI 4.06-4.6). Results for post-curriculum trainees trended higher for each section at 4.22 (95%CI 4.04-4.40) (p = 0.4738), 3.84 (95%CI 3.52-4.16) (p = 0.5279), and 4.49 (95%CI 4.21-4.77) (p = 0.4534). CONCLUSIONS: Implementation of a structured, longitudinal POCUS curriculum resulted in a trend towards improved trainee confidence, satisfaction, and perception of POCUS. Future studies are needed to identify the optimal structure for POCUS educational content delivery and competency assessment for EM resident providers.


Asunto(s)
Competencia Clínica , Curriculum/normas , Educación de Postgrado en Medicina , Medicina de Emergencia/educación , Sistemas de Atención de Punto , Ultrasonografía/normas , Adulto , Evaluación Educacional , Humanos , Internado y Residencia , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos
11.
Emerg Radiol ; 27(3): 253-258, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31919617

RESUMEN

PURPOSE: Diagnostic computed tomography (CT) imaging, utilizing intravenous (IV) contrast administration, has become increasingly common. Potential IV contrast-associated complications include local skin and soft tissue reactions due to extravasation. The goal of this study is to describe the risk of contrast extravasation based on IV catheter anatomic location in patients receiving contrast-enhanced CT imaging. METHODS: The study was conducted as a retrospective cohort study of patients receiving contrast-enhanced CT imaging performed over a 26-month period at a single institution. The rate of contrast extravasation was calculated by IV catheter vessel anatomic location and compared by relative risk (RR) and absolute risk reduction (ARR). RESULTS: Of 17,767 contrast administrations for CT imaging studies performed, 14,558 met study inclusion criteria. Forty-nine (0.34%) extravasation events were identified. Forty-one (0.28%, 95% CI 0.21-0.39%) extravasation events were observed in 14,275 peripheral IV catheters placed in a non-upper arm location. Eight (2.8%, 95% CI 1.3-5.3%) extravasation events were observed in 283 IV catheters placed, most commonly with point-of-care ultrasound (POCUS) guidance, in upper arm vessels (RR 10.1, 95% CI 4.69-21.8). Non-upper arm located IV catheters were associated with an ARR of 2.54% (95% CI 0.61-4.47%) when compared to upper arm catheters. CONCLUSIONS: IV catheter placement in upper arm vessels is associated with a relatively minimal increase in extravasation risk when compared to catheters placed in a non-upper arm location. In patients without alternative available peripheral vascular access, POCUS-guided upper arm IV cannulation may be an appropriate approach.


Asunto(s)
Medios de Contraste/administración & dosificación , Extravasación de Materiales Terapéuticos y Diagnósticos , Tomografía Computarizada por Rayos X , Femenino , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
12.
Chemistry ; 24(55): 14824-14829, 2018 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-30076653

RESUMEN

The backbone of 2-hydroxyisophthalic acid was identified as a potential metal oxide anchor because of the perfect alignment of all three of its donor groups for binding to inorganic surfaces. It can therefore be used in the design of organic linkers for metal oxide based hybrid materials. Optimized and scalable methods for the synthesis of 2-hydroxyisophthalic acid (1) and its 5-substituted derivatives: 5-bromo- (2), 5-sulfooxy- (3), 5-hydroxy- (4), and 5-PEG600 (5) are presented. Dynamic light scattering (DLS) demonstrated that compound 2 inhibits Fe(OH)3 precipitation when FeIII aqueous solutions are titrated with NaOH, while similar titrations in the presence of the structurally-related isophthalic and salicylic acids, both missing the third donor group, show turbidity at pHs as low as 2.3 and 3.5, respectively. The adduct synthesized from 4.5 nm γ-Fe2 O3 nanoparticles and 5 is water-, alcohol- and CH2 Cl2 -soluble, and forms stable aqueous colloids in the pH range of 4.4-8.7. Moreover, at a pH close to neutral these colloids survive at 100 °C, demonstrating the high practicality of 2-hydroxyisophthalic acid for nanoparticulate inorganic/organic hybrid material design.

13.
Environ Sci Technol ; 52(5): 2595-2602, 2018 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-29429338

RESUMEN

Benzotriazole UV stabilizers (BT-UVs) have attracted increasing attention due to their bioaccumulative nature and ubiquitous presence in surface waters. We apply high-frequency sampling in paired watersheds to describe, for the first time, the behavior of BT-UVs in stream channels during snowmelt and rainfall. Relative to a largely agricultural watershed, concentrations of BT-UVs in an urban watershed were 4-90 times greater during rainfall and 3-21 times greater during snowmelt. During rainfall, a decrease in BT-UV concentrations on particles with increasing suspended sediments and streamflow occurred at all urban sites due to input of relatively clean sediments, while both decreases and increases were observed at rural sites. Where increases occurred in the rural watershed, road sediments were consistently suggested as the source. Contrasts between the urban and rural sites were also observed during snowmelt. While BT-UV concentrations on particles peaked with peak suspended sediment levels at urban stream sites, the opposite was true at rural stream sites. This appeared to be driven partially by different snowpack melt rates in the two watersheds, with earlier melt and presumably higher streamflow facilitating suspension or erosion of more contaminated sediment in the urban stream. In general, it appears that relatively high, consistent emissions in the form of informal (plastic) debris disposal by consumers or industrial releases have likely led to more homogeneous BT-UV profiles and temporal behavior in the urban watershed. In the rural watershed, low emissions instead entail that emissions variability is more likely to translate to variability in chemical profiles and temporal behavior.


Asunto(s)
Monitoreo del Ambiente , Urbanización , Ríos , Triazoles
14.
Environ Sci Technol ; 51(8): 4191-4198, 2017 04 18.
Artículo en Inglés | MEDLINE | ID: mdl-28351142

RESUMEN

While benzotriazoles (BTs) are ubiquitous in urban waters, their sources and transport remain poorly characterized. We aimed to elucidate the origin and hydrological pathways of BTs in Toronto, Canada, by quantifying three BTs, electrical conductivity, and δ18O in high-frequency streamwater samples taken during two rainfall and one snowmelt event in two watersheds with contrasting levels of urbanization. Average concentrations of total BTs (∑BT) were 1.3 to 110 times higher in the more urbanized Mimico Creek watershed relative to the primarily agricultural and suburban Little Rouge Creek. Strong correlations between upstream density of major roads and total BT concentrations or BT composition within all events implicate vehicle fluids as the key source of BTs in both watersheds. Sustained historical releases of BTs within the Mimico Creek watershed have likely led to elevated ∑BT in groundwater, with elevated concentrations observed during baseflow that are diluted by rainfall and surface runoff. In contrast, relatively constant concentrations, caused by mixing of equally contaminated baseflow and rainfall/surface runoff, are observed in the Little Rouge Creek throughout storm hydrographs, with an occasional first flush occurring at a subsite draining suburban land. During snowmelt, buildup of BTs in roadside snowpiles and preferential partitioning of BTs to the liquid phase of a melting snowpack leads to early peaks in ∑BT in both streams, except the sites in the Little Rouge Creek with low levels of vehicle traffic. Overall, a history of BT release and land use associated with urbanization have led to higher levels of BTs in urban areas and provide a glimpse into future BT dynamics in mixed use, (sub)urbanizing areas.


Asunto(s)
Agua Subterránea , Ríos , Agricultura , Canadá , Monitoreo del Ambiente , Urbanización
15.
J Clin Ultrasound ; 45(7): 408-415, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28164320

RESUMEN

PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN]). Survey questions aimed to describe consultant's confidence and utilization of EM-POCUS. Responses were evaluated using descriptive and comparative analysis. RESULTS: Survey responses were obtained from 27 IM (87.1%), 13 GS (100%), and 21 OB-GYN (100%) respondents. Among consultant specialties, 47.5% of respondents reported comfort with EM-POCUS. IM (81.5%) providers were significantly more likely to trust EM-POCUS as compared with OB-GYN (28.6%) and GS (7.7%) providers (p < 0.001). Confidence was further limited when consultants were unable to view POCUS images (23.8% for OB-GYN, 15.4% for GS, 55.6% for IM), but improved with EM provider level of POCUS experience and training (81% for OB-GYN, 76.9% for GS, 77.8% for IM). Overall, consultant utilization of EM-POCUS was 68.9%. CONCLUSIONS: Study respondents demonstrated limited confidence and utilization of EM-POCUS in this institution. Increased understanding of EM-POCUS training and expanded image availability may improve consultant utilization. Future studies, performed nationally, should further describe the value of EM-POCUS to consultant services. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:408-415, 2017.


Asunto(s)
Actitud del Personal de Salud , Servicio de Urgencia en Hospital/estadística & datos numéricos , Médicos/estadística & datos numéricos , Sistemas de Atención de Punto/estadística & datos numéricos , Ultrasonografía/métodos , Centros Médicos Académicos , Medicina de Emergencia , Humanos , Derivación y Consulta
16.
Bull Environ Contam Toxicol ; 99(6): 673-678, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29063129

RESUMEN

Mercury (Hg) methylation is often elevated at the terrestrial-peatland interface, but methylmercury (MeHg) production at this "hot spot" has not been linked with in situ biotic accumulation. We examined total Hg and MeHg levels in peat, invertebrates and tissues of the insectivore Sorex cinereus (masked shrew), inhabiting a terrestrial-peatland ecotone in northern Minnesota, USA. Mean MeHg concentrations in S. cinereus (71 ng g-1) fell between concentrations measured in spiders (mean 70-140 ng g-1), and ground beetles and millipedes (mean 29-42 ng g-1). Methylmercury concentrations in S. cinereus increased with age and differed among tissues, with highest concentrations in kidneys and muscle, followed by liver and brain. Nearly all Hg in S. cinereus was in the methylated form. Overall, the high proportional accumulation of MeHg in peat at the site (3.5% total Hg as MeHg) did not lead to particularly elevated concentrations in invertebrates or shrews, which are below values considered a toxicological risk.


Asunto(s)
Monitoreo del Ambiente , Contaminantes Ambientales/metabolismo , Invertebrados/metabolismo , Compuestos de Metilmercurio/metabolismo , Musarañas/metabolismo , Animales , Bosques , Mercurio/análisis , Minnesota , Suelo
17.
Environ Sci Technol ; 49(15): 9143-9, 2015 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-26151306

RESUMEN

Soil mercury (Hg) emissions are an important component of the global Hg cycle. Sunlight induced photoreduction of oxidized Hg to gaseous elemental Hg is an important mechanism controlling emissions from the soil surface, however we currently understand little about how subsurface Hg stores participate in gaseous Hg cycling. Our study objective was to investigate the ability of Hg at deeper soil depths to participate in emissions. Soil fluxes were measured under controlled laboratory conditions utilizing an enriched stable Hg isotope tracer buried at 0, 1, 2, and 5 cm below the surface. Under dry and low-light conditions, the Hg isotope tracer buried at the different depths participated similarly in surface emissions (median flux: 7.5 ng m(-2) h(-1)). When the soils were wetted, Hg isotope tracer emissions increased significantly (up to 285 ng m(-2) h(-1)), with the highest fluxes (76% of emissions) originating from the surface 1 cm amended soils and decreasing with depth. Mercury associated with sandy soil up to 6 cm below the surface can be emitted, clearly demonstrating that volatilization can occur via processes unrelated to sunlight. These results have important implications for considering how long older, legacy soil Hg contamination continues to cycle between soil and atmosphere.


Asunto(s)
Gases/análisis , Mercurio/análisis , Contaminantes del Suelo/análisis , Suelo/química , Isótopos de Mercurio , Estadísticas no Paramétricas , Luz Solar , Humectabilidad
18.
Environ Pollut ; 341: 122966, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-37981183

RESUMEN

Methylmercury (MeHg) is the most neurotoxic and bioaccumulative form of mercury (Hg) present in the terrestrial and aquatic food sources of boreal ecosystems, posing potential risks to wildlife and human health. Harvesting impacts on Hg methylation and MeHg concentrations in forest soils and stream sediment are not fully understood. In this study, a field investigation was carried out in 4 harvested and 2 unharvested boreal forest watersheds, before and after harvest, to better understand impacts on Hg methylation and MeHg concentration in soils and stream sediment, including their responses to different forest management practices. Changes in total Hg (THg) and MeHg concentrations, first-order potential rate constants for Hg methylation and MeHg demethylation (Kmeth and Kdemeth) as well as total carbon content and carbon-to-nitrogen ratio post-harvest in upland, wetland and riparian soils and stream sediment were assessed and compared. Increases in MeHg production were minimal in upland, wetland or riparian soils after harvest. Sediment in streams with minor buffer protection (∼3 m), greater fractions (>75%) of harvested watershed area and more road construction had significantly increased THg and MeHg concentrations, %-MeHg, Kmeth and total carbon content post-harvest. From these patterns, we infer that inputs of carbon and inorganic Hg into harvest-impacted stream sediment are likely sourced from the harvested upland areas and stimulate in situ MeHg production in stream sediment. These findings indicate the importance of stream sediment as potential MeHg pools in harvested forest watersheds. The findings also demonstrate that forest management practices aiming to mitigate organic matter and Hg inputs to streams can effectively alleviate harvesting impacts on Hg methylation and MeHg concentrations in stream sediment.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Contaminantes Químicos del Agua , Humanos , Mercurio/análisis , Ecosistema , Ríos , Taiga , Suelo , Contaminantes Químicos del Agua/análisis , Bosques , Carbono , Monitoreo del Ambiente
19.
Water Res ; 253: 121332, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38377924

RESUMEN

Photodegradation is critical to reduce the potent neurotoxic methylmercury (MeHg) in water and its subsequent accumulation along food chains. However, this process has been largely ignored in rice paddies, which are hotspots of MeHg production and receive about a quarter of the world's developed freshwater resources. Here, we reported that significant MeHg photodegradation, primarily mediated by hydroxyl radicals, occurs in the overlying water during rice growth. By incorporating field-measured light interception into a rice paddy biogeochemistry model, as well as photodegradation rates obtained from 42 paddy soils stretching ∼3500 km across China, we estimated that photodegradation reduced MeHg concentrations in paddy water and rice by 82 % and 11 %, respectively. Without photodegradation, paddy water could be a significant MeHg source for downstream ecosystems, with an annual export of 178 - 856 kg MeHg to downstream waters in China, the largest rice producer. These findings suggest that photodegradation in paddy water is critical for preventing greater quantities of MeHg entering human food webs.


Asunto(s)
Mercurio , Compuestos de Metilmercurio , Oryza , Contaminantes del Suelo , Humanos , Mercurio/análisis , Ecosistema , Agua , Fotólisis , Contaminantes del Suelo/análisis , Monitoreo del Ambiente , Suelo , Oryza/metabolismo
20.
Cell Stem Cell ; 31(7): 1020-1037.e9, 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38754428

RESUMEN

Autophagy is central to the benefits of longevity signaling programs and to hematopoietic stem cell (HSC) response to nutrient stress. With age, a subset of HSCs increases autophagy flux and preserves regenerative capacity, but the signals triggering autophagy and maintaining the functionality of autophagy-activated old HSCs (oHSCs) remain unknown. Here, we demonstrate that autophagy is an adaptive cytoprotective response to chronic inflammation in the aging murine bone marrow (BM) niche. We find that inflammation impairs glucose uptake and suppresses glycolysis in oHSCs through Socs3-mediated inhibition of AKT/FoxO-dependent signaling, with inflammation-mediated autophagy engagement preserving functional quiescence by enabling metabolic adaptation to glycolytic impairment. Moreover, we show that transient autophagy induction via a short-term fasting/refeeding paradigm normalizes glycolytic flux and significantly boosts oHSC regenerative potential. Our results identify inflammation-driven glucose hypometabolism as a key driver of HSC dysfunction with age and establish autophagy as a targetable node to reset oHSC regenerative capacity.


Asunto(s)
Autofagia , Glucólisis , Células Madre Hematopoyéticas , Inflamación , Animales , Células Madre Hematopoyéticas/metabolismo , Inflamación/patología , Inflamación/metabolismo , Ratones , Ratones Endogámicos C57BL , Envejecimiento/patología , Envejecimiento/metabolismo , Senescencia Celular , Transducción de Señal , Proteína 3 Supresora de la Señalización de Citocinas/metabolismo , Glucosa/metabolismo
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